Recognizing Self-Neglect

Self-neglect is most often reported because of unusual or dangerous behaviors are recognized in a loved-one. Because these features take months-to-years to develop, friends and family may not notice the change as being significant. Eventually, there is an event that makes clear that there is self-neglect.

Research and observation indicates that self-neglect does not have one set of features (Burnett et al., 2014). There appears to be different types of self-neglect that can have been categorized in different ways (see Types of Self-Neglect).

Not paying the bills because they either forget or the bills are lost in the clutter

Mental

Decreased ability to reason

Confusion

Depression

Psychosis; such as hallucinations

Refuse to consider health care provider’s recommendations

Geriatric Care Manager Perspective

Two hundred and eighty eight geriatric care managers from the National Association of Professional Geriatric Care Managers (NAPGCM) completed a survey in September of 2014 (Boothroyd, 2014). The results of the survey are as follow:

92% say that elderly self-neglect was a significant problem in their community,

52% believe that self-neglect is significant and growing problem,

94% agree that elderly self-neglect is a largely hidden problem with cases frequently or mostly going unreported, and

76% report that self-neglect is the most common non-financial form of elder abuse/neglect that they deal with in practice.

According to the NAPGCMs, there are 6 warning signs of self-neglect that they see in practice often. Each sign is followed by the percentage of NAPGCMs who agreed:

Evidence of dehydration, malnutrition or other unattended health conditions (75%)

Unsanitary/very unclean living quarters (72%)

Signs of unpaid bills, bounced checks or utility shut-offs (64%)

Evidence of missing adequate food in house or signs of weight loss (63%)

Culture

Different cultures and beliefs may not agree on what is a normal level of comfort, material goods, necessities, health, and hygiene. This makes assessing and treating self-neglect very difficult. It requires specialized knowledge in healthcare, sociology, and ethics (Day & Leahy-Warren, 2008; Gibbons et al., 2006).